Provider Demographics
NPI:1912254335
Name:WILLIAMS, ELIZABETH ASHLEY (LPN)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ASHLEY
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:ELIZABETH
Other - Middle Name:ASHLEY
Other - Last Name:GODWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:6207 SOUTHWIND CT
Mailing Address - Street 2:
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-8629
Mailing Address - Country:US
Mailing Address - Phone:919-906-4874
Mailing Address - Fax:
Practice Address - Street 1:1214 VAUGHN RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27217-2863
Practice Address - Country:US
Practice Address - Phone:336-532-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC72298164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse